AU604521B2 - Instrument for prevention of constrictions in the joint area at the appliance of branching on vessel - Google Patents

Description

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A-AI-1083f6/86 WORLD INTELLECTUAL PROPERT)' ORGANIZATiON Irflem~ational Bureau INTERNATIONALAPPLICAN Uf (51) International Patent Ciassil'itation4 A61IB 17/00, 17/11, A61 M 29/02 COOPERATION TREATY (PCT) 43) Itenation)l Publication Date: 30 June 1988 (30.06,88) (21) Internationmi Application Number: PC-T/SE87/00596 (22) International Filing Date: I11 December 1987 (11.12.87) (31) P'riority Application Number: 8605455-8 (32) Priority Date: (33) Priority Country: 18 December 1986 (18.12.86) (71) Applicant (for all designated States except US), UN- ILINK INC, (US/US]; PO, Box 720, Centreville, VA 22020 (US), (72) Inventors; and Inventors/Applicants (for US only) :BERGGREN, Anders [SE/SE]; Bergdalsgatan 6, S-582 45 Link~ping ROHMAN, H~kan [SE/SE]t Vitsippestigen 4, S- 590 20 Mantorp RAGNARSSON, Rafn [SE/ SE]; Kvinnebyvagen 131, S-582 60 Linkbping (SE).

(74) Agents: ONN, Thorsten et al,; AB Stockholms PatentbyrA, Zacco Bruhn, Box 3129, S-103 62 Stockholm

(SE),

(81) Designated States: AT (European patent), 'AU, BE 'European patent), BR, CH (European patent), DE (European patent), DK, FR (European patent), GB (European patent), IT (European patent), LLU (European patent), NL (European patent), SE (European patent). US, Published With, international search report, A.Oj-p- 18 AUG 1988 I AUSTRALIAN I15 JUL 1988 PATE NT OFFICE (5)ll:ISRMN O REETO FCNTITOSIMTEJITAE TTEAPI rdo c~mment contins the anie, n.3 nade utnde~r Section 0i and is correct for Iprinting.

ANCE OF BRANCHINSG ON VESSEL (57) Abstract 1 I* i.

Instrument for use at the applying of branching on vessel by means of anast:)mosis rings in order to prevent constrictions in the joint area,-Which is T'shaped, the vertical part of the T being constituted by an unyielding pipe or hose whereas the upper part of the T is elastic, The upper part of the T constitutes a diosed space but for a connection with the vertical hose dr pipe, The upper part of the instrument can in evacua,"ed state be inserted through a cut. in a vessel wall, then 4o be blown up to expand the vessel, before an anastomosis end to side is conducted by means of an anas,, tomosis ring.

i 'WO 88/04539 PCT/SE87/00596 1 Instrument for prevention of constrictions in the joint area at the appliance of branching on vessel In the vessel surgery it has become increasingly useful with by-passes, i.e. for instance constricted vessels are replaced by healthier ones that are coupled in parallel or that vessels are connected at other places than originally. Up till now one has used the technique of sewing the vessels together by means of sutures. It has however been found that anastomosis rings can be used to make anastomosis "end to side". When this is done the vessel that is to be branched off is punctuated by a small cut that is then flared and the vessel is placed over the pins of the anastomosis ring.In this way it is possible to make the branching or by-passin 6 considerably faster than with a conventional sewing technique. In this way the resources are better used and the risks for the patient are diminshed.

Regretfully this way of conducting an end to side operation is not entirely without draw-backs. It has namely been found that the applying of the anastomosis ring so to say steals material from the vessel to which the branching is coupled and results in a constriction which definitely is undesirable since the by-pass is applied in order to improve the flow. In view of this problem the invention has as it's object to provide an instrument eliminating this draw-back.

In accordance with the invention these problems are solved by means of a T-shaped instrument where the upper part of the T in principal is constituted by an el-a.stically expandable part that in the most simple case cai'be constituted by a piece of a thin-walled hose,the vertical part of the T being constituted by another hose connected with a pressure source. This pressure source can for instant be a common injection syringe. By providing a medium under pressure to the elastic upper part of the T this can be expanded and by evacuating this part it can also be made i; WO 88/04539 PCT/SE87/00596 2 very thin and easy to handle. At use the upper parts of the T are each inserted in different directions in the vessel through the little cut where the branching is to be placed. When the parts of the Tare well inserted into the vessel they are expanded and the vessel is expanded to about twice of it's original diametre. The instrument is then evacuated and removed from the vessel and an anastomosis ring and the additional vessel end can be connected. Since the vessel is not entirely elastic it will retain it's expansion for sufficient time to secure that no constriction occure despite the use of an anastomosis rine for the connection. Tests have shown that no tendency whatever prevail for a rupture or a tearing of the cut in the vessel during the expansion of this. The reason for this may be the very uniforme stress that the vessel is subjected to in comparison with what would be the case if one tries to expand the vessel by means of pincettes or the like.

The invention is below to be described in connection with the drawing, where fig. 1 shows an embodiment in accordance with the invention seen from the side at rest and fig. 2 the same instrument seen from the side and fig. 3 shows the instrument in it's so to say working state.

The instrument shown in fig. 1 is constituted by a thick-walled connection hose 1 of plastic, which has been welded to a side-opening 2 in a thin-walled elastic plastic hose 3. This hose 3 is furthermore at it's ends 4 and 5 welded together. The hose 1 is very thin and has preferably such a diameter that it f.ts on the tip.71f an injection syringe. In fig. 3 finally the instrument has been subjected to pressure resulting in that the thin-walled upper part of the instrument has been expanded.

On the drawing the instrument is of course shown enlarged, in reality the diameter of the connection hose 1 is about 1 mm whereas "the balloonpart" has a diameter of about 2 mm and the length of this upper balloonpart is about 8 mm -7 WO088/04539 PCT/SE87/00596 in unaffected state. Finally it should be mentioned that the instrument is very hygenic and economic to produce.

Claims (2)

1. An instrument for prevention of constrictions by means of expansion at a joint area which results from surgical branching of blood vessels utilizing anastomosis rings, wherein said instrument is substantially T-shaped, a vertical part of the T-shape being constituted by a substantially unyielding pipe or hose, and an upper part of the T-shape being elastic substantially in its entirety and adapted to form a closed space but for a connection with the vertical part. O* O 0 000 S 05O5 0 6000: 0005 0 05 S 000* 0* S. S S. S F~ 1a"4 mmm:1 m mi d U

4. ^LAIMSDB~F-INING THE INVNTIONn FLLO--. 1. An instrument for prevention of constri ons at a joint area which results from surgical br ing of blood vessels by means of anastomosis ri wherein said instrument is substantiall shaped, a vertical part of the T-shape being consti d by a substantially unyielding pipe or hose, and npper part of the T-shape being elastic and adapted form a closed space but for a connection with the inal pArt- 2. An instrument according to claim 1, wherein the upper part is a thin-walled elastic hose that has closed ends and is in fluid communication with the vertical part. 3. An instrument according to claim 1 or 2, wherein the upper part is substantially 8 mm long and 2 mm in Sdiameter in unpressurized state. 0 *0 4. An instrument according to any one of the preceding claims, wherein the vertical part is substantially 1 mm in diameter and thick-walled. An instrument as claimed in claim 1, substantially as herein described with reference to the accompanying drawisngs. DATED this 5th day of January, 1990. UNILINK, INC. *0 WATERMARK PATENT TRADEMARK ATTORNEYS, 290 BURWOOD ROAD, HAWTHORN, VICTORIA, AUSTRALIA. LJD:RCTS:BB(7,15) 0%